America’s healthcare insurance system has too many moving parts. Every extraneous moving part diminishes efficiency and increases the number of dark corners in coverage where vermin thrive.
Blame capitalism; capitalism is competitive, not cooperative. Healthcare can’t be competitive, but healthcare insurance is, as it should be, competitive as hell. The dichotomy creates absurdities, both logical and financial.
Don’t sprain yourself, we can see you waving: “What do you mean, healthcare is cooperative? Healthcare isn’t cooperative!”
If healthcare was competitive, rather than cooperative, there would be piles of dead bodies in every hospital parking lot. We’re exaggerating; they’d have them removed, but it would be a genuine problem. People would die because they lost the healthcare insurance competition.
Some would die because they couldn’t afford to pay for healthcare, some would die because they didn’t understand their healthcare plans, and some would die because fake healthcare insurance companies fleeced them, leaving them holding healthcare policies as useless as piles of Monopoly money.
Medical professionals, unbound by cooperative concepts like the Hippocratic Oath or human charity, would ignore anyone not waving a thick wallet or a valid insurance plan, leaving them to pray. self-medicate or join the body pile. This is common in some areas of the world.
Not here, though. American medical professionals don’t refuse patients in dire need. it’s comforting that our society – the part of the world we live in – remains at heart a kind, caring society. We feed our hungry and we care for our sick and infirm, even when we know they have no means to pay. Charity is one of the nicest of all human traits. It’s beautiful. It’s sweet. It’s kind.
And it’s expensive.
There are bills that have been in circulation for decades, floating around like ghostly little IOU slips. that will never be paid. Insurance companies and medical professionals have to compensate for the lost revenue, so they overcharge those who pay to cover those who don’t. In a competitive system nobody volunteers to pay the insurance company’s bills, so this is how it has to work.
Is this what we want? Should sick and injured citizens without medical insurance be given access to expensive care without bearing any responsibility, while the working poor overpay for confusing, manipulative insurance plans to cover their overpriced medical bills? Should restaurants be obligated to feed everyone who walks through their front door, then charge these “free” meals to their other customers?
We need a system that requires every American to take responsibility for his or her future healthcare needs. We need a national healthcare umbrella that will cover everyone, designed with safeguards so it won’t fold up the first time it rains. Hospitals need the freedom to serve anyone who needs care, without worrying about who will pay for it.
In order to reconcile the two incompatible financial models – competitive with cooperative – there has to be some sort of buffer, a payment-to-coverage ligament, that holds the competitive insurance markets and the cooperative healthcare markets together. We need a system where the afflicted will know they are covered, but also a system where the bills will be paid. There is no such thing as a free lunch; the buffer has to account for that harsh but unavoidable fact.
That buffer exists. It already covers nearly 10 million Americans. It might even cover you.
The model for our buffer, the single-payer conduit that keeps both sides in line so they don’t try to kill each other, is the Veteran’s Health Administration. The VHA can be converted and expanded into a national single-payer health system; already has in place priority mechanisms for payment through national service, and its outlets are used to dealing with a single insurance provider.